Sina Phin, a garment worker, right, ironing shirts at the New Island factory in outlying Phnom Penh, Cambodia, in April 2005. (Photo: Michael Nagle / The New York Times)

About a year ago, record numbers of garment laborers in factories across Cambodia - which exports 70 percent of the garments manufactured there to the US - were reported to be suddenly and mysteriously falling to the ground, unconscious. Hundreds at a time - sometimes less, although sometimes more. Workers at many scenes reported foul smells, difficulty breathing. Halting investigations took place at select plants by various parties involved: government officials; labor unions; human rights groups; business associations; monitoring organizations; and, weirdly, the international big-name brands that sell the clothes being made. A consortium of factors was considered: hypoglycemia, the direct result of workers not eating enough; minor factory infractions that managers promised to address immediately; a common cold outbreak emanating from Canada; overwork; mass hysteria; workers partying too hard over the weekend; and spiritual possession. In the end, no single cause was named for the nationwide epidemic. Besides a 5$ "health bonus" for qualifying workers, no sweeping policy changes were offered to keep the incidents from continuing.

It seemed to be just more bad luck for Cambodia, a nation still coming to terms with five decades spent surviving a record tonnage of American bombs, the Khmer Rouge, a generation of civil war, a legacy of corruption and endemic poverty. But bad luck doesn't account for around 3,000 workers reportedly losing consciousness in 17 separate mass-fainting incidents at 12 of the country's 300 registered garment factories.

The real bad luck for Cambodia - and ethical apparel consumers, particularly in the US, where 70 percent of the goods produced are sold - is that thousands of workers falling ill on the job isn't enough to catch the fashion industry's attention.

Background

Life in the Cambodian garment factories is not what anyone would call easy, even under ideal conditions. The minimum wage was increased to $61 per month at the beginning of 2011, still significantly less than the $93 per month living wage. But garment workers don't just cover their own costs - about a fifth of the country's 14 million people rely on their paychecks to support rice farms in the provinces. (That's right, the developing country's third-largest income generator, garment work, supports the country's second - agriculture.) Many workers labor seven days per week and take on as much overtime as possible, to earn enough to send $50 or $60 home every month. A tiny rental near the factories costs around $25 per month - you can get something bigger to split among more workers, although rents of less than $15 per month are rare - and utilities run between $5 and $10 per month. Drinking and cooking water costs have to be covered, too. And transportation, if needed. Even with the wage increase, funds are tight.

Everyone skimps on health care, which under the Pol Pot regime thirty-five years ago meant untrained cadre inventing balms and pills with accessible materials like leaves, mud and dung, since doctors were purged alongside intellectuals and previous government officials. The country is still rebuilding, and while health facilities are supposed to be provided in factories, they're often insufficient.

Many skimp on food. It's hard to eat in Cambodia for less than $1.25 per day. A 2009 Cambodian Institute of Development Study found that workers are often left with between $4 and $9 per month for meals. Workers who faint from hunger or the stifling heat on the factory floor - it's common enough - may find themselves without a job when they awake.

Unions have a robust life and that would seem, from a distance, to help. There are 650 registered unions in Cambodia, operating in the 300 registered factories. But yellow unions - company-backed organizations that push through management decisions - are common, as are competitive unions within one factory. Occasionally, two different unions that are members of the same federation will operate competing branches. With an average of six unions per factory, there's a lot of in-fighting and little in the way of actual organizing. On top of which, the all-male union leadership tends to act with little regard for female workforce concerns.

One shining example of union impotency was a series of strikes from September 13 through 16, 2010. Of the 300,000-strong workforce at the time, between one- and two-thirds had walked off jobs to demand a raise to the minimum wage - then only $55 per month. Management reaction was swift and strange: 26 labor leaders were "banned" from jobs. Not fired - that would violate laws protecting workers' rights to organize - just not allowed to enter buildings where they worked. Cohesive demands for more money splintered into protests against what amounted to illegally fired workers. These were met with more illegal firings, which led to more protests and increasing violence on all sides. The number of laborers effectively out of work over what was originally a demand for a wage increase quickly grew - some estimate into the thousands. Even after things calmed down in January 2011, some 300 illegally fired workers remained out of work at 20 factories around the country.

The back story to the mass fainting incidents is this: During the last months of 2010, up to two-thirds of the entire Cambodian garment industry had cohesively come together to make demands as a unified voice, in a democratic nation, with legal protection for workers' rights to organize. Yet somehow, one organizer told me, "Nothing happened." She looked crushed.

The Domino Effect

A few months after these mass, failed protests, huge numbers of workers started falling to the ground. Coverage of mass faintings in the press began with an incident on April 9 and 10, 2011, when 300 employees of the Huey Chuen garment factory and, next door, 500 employees of Universal Apparel Co. Ltd., fainted, according to both Reuters and The Guardian UK. (Deutsche-Press Agentur originally claimed 200 workers fell that day; Agence France-Presse listed only 101. These discrepancies were later attributed to counts based on hospitalized, instead of injured, workers, at two distinct sites.) The Guardian UK reported that, on June 15, 200 more employees experienced "a bad smell" before collapsing at King Fashion Garment, also in Phnom Penh. The next day, according to the same paper, another 100 fell. Fashion-industry news site Just-style.com notes that on July 25, 49 more workers were hospitalized after another incident at Huey Chuen garment factory, a story confirmed by Deutsche-Press Agentur. That same day, around 100 workers fainted at Hung Wah Textiles in the capital city, reported VOA Khmer. (Reuters claims 300 workers fell in July, but does not provide a date, wefhile other sources claim a mass fainting incident took place on July 21. Neither were confirmed by other sources.) On August 24, 85 more workers fainted after complaining of unusual odors at the M&V International Manufacturing, Ltd. plant in the central Kampong Chhnang province, according to Reuters, which reported nearly 200 more workers collapsing at the same factory the next day. On August 26, Radio Free Asia (RFA) told of 20 workers losing consciousness at the Shingly Garment Factory in the capital. Four days later, the station reported, more than 100 workers had collapsed on the job at the Chime Ly Garment Factory in the Kandal province in southern Cambodia. More smells were reported there; this time, guards outside factory doors fainted, too. Then, on August 31, more than 50 workers fell at Heart Enterprise Garment Factory in southern Kandal province, according to RFA.

For a time, the faintings were eclipsed by the big-name brands rushing to look into them. Swedish clothing retailer H&M, which buys garments from the M&V and Hung Wah plants, investigated over the summer. In a July 22 email to Reuters, the company stated, "Worker's health and safety in our supplier factories is of high priority to H&M. Accordingly, we have immediately started investigations ..." German sportswear company Puma, the sole purchaser of shoes made in the Huey Chuen factory, had the Fair Labor Association (FLA) draw up a report.

Findings were mixed: H&M, the world's second-largest clothing manufacturer, concluded their investigation by the end of August. No "plausible causes" had been discovered for the faintings, Just-style.com reported. The FLA, a non-profit organization funded by affiliate clothing, footwear and consumer goods companies, boasts a mission to promote adherence to national and international labor laws. Although the organization stands accused of deep conflicts of interest that cast shadows over all findings - releasing glowing reports of Foxconn factories in China paid for by Apple, for example - even it noted clear violations of domestic labor law and Puma's contractor code of conduct, as well as worker malnutrition at the Huey Chuen plant. On July 26, Just-style.com reported only that hypoglycemia had been diagnosed.

The Cambodian government got into the act, too. Following the Heart Enterprise incident, the ministers of industry, labor, social affairs and health portfolios inspected the factory and condemned it for unhygienic conditions and overcrowded workspaces. Factory management, however, wrote the incident off as having been caused by "spiritual possession," RFA reported on August 31. (Ken Loo, secretary general of the Garment Manufacturing Association of Cambodia, or GMAC, theorized that since "many incidents of mass fainting in Cambodian factories have occurred on a Monday ... workers may have become over-involved with social activities on the weekend before returning to work," RFA reported on February 14.)

A brief pause, then more mass faintings. On October 24, 100 (RFA listed a remarkable 1,000 and the Australian Broadcasting Company, or ABC, reported 136) workers fell ill at the Anful Garment Factory - another producer for H&M - in southern Kampong Speu Province, according to Reuters. The factory closed for two days - claiming to give workers time to rest, although foul smells from an insecticide sprayed on shirts on Sunday had been reported - and when the factory opened again on October 27, over 200 more workers fainted. (ABC listed 100.)

Toward the end of 2011, reports of mass faintings become more sporadic and fewer are confirmed by multiple sources. On December 8, China Daily reported 59 workers collapsed at the Sportex Industry factory in Phnom Penh. On January 24, 2012, the Cambodia Daily reported 60 workers fell at the Taiwanese-owned King First Industrial Co Ltd. in the capital. RFA reported 300 workers fainted at Nanguo Garment Co. Ltd. in Sihanoukville, southwest of the capital, on February 14. (The Phnom Pehn Post confirms only 201 faintings that day.) On March 6, the Post reported 50 more workers fell at the same factory.

The stories conflict and at times contradict. While exact numbers of fainted - as opposed to ill, hospitalized or fallen - workers are disputed, that a record numbers of faintings took place was never questioned. Causes were offered. Plausible, comprehensive explanations were not.

Causes

Part of the story here is that garment factory faintings sort of aren't news. Many factories admit to as many as between one and five per week and the Phnom Penh Post reported 20 workers had fainted at M&V before these incidents started occurring, on September 23, 2010. At a Kampong Cham high school in November 2011, school officials intended to quell concerns about the ongoing incidents around the country. The Post reported that 136 students in attendance lost consciousness. It's a hot country, with not a lot of wind. People faint.

Time, however, isn't buying it - a shame, as it was among the only major US media outlets to acknowledge the mass faintings at all. Noting only seven of the nine incidents that had taken place by the article's appearance on September 20, 2011, Andrew Marshall described them as mass hysteria, "a bizarre yet surprisingly common phenomenon that is increasingly recognized as a significant health and social problem," and wrote the incidents off as "psychogenic fainting."

Marshall's unresearched pronouncement smacks of privilege, misogyny and racism - look what those crazy brown women are doing now! - but more problematic, doesn't account for a single environmental factor suggested by eyewitness accounts.

"There is a strong possibility that the fainting and illness reported are due to the type of chemicals used in the factory and the way they are used," the Fair Labor Association noted in the July 18, 2011, report on the Huey Chuen incidents. "While there are a large number of ventilation fans, these do not appear to be effective ... [and] a chemical was found that, according to the producers' website, contains toluene."

Use of toxic toluene - the chemical at work in "huffing" - is a violation of Puma's supplier factory regulations. The Environmental Protection Agency claims the solvent damages the central nervous system. Low levels of the stuff can cause dizziness, while at moderate levels, a loss of consciousness.

While toluene wasn't found at each site - an athletic shoe manufactory will have a different set of environmental factors than garment plants - Greenpeace released a commissioned report called "Dirty Laundry 2" on August 23, 2011, that could point to the use of other toxins. The report stated that nonylphenol ethoxylates (NPEs), banned in the UK, are being found in clothes from top labels - including H&M and Puma, as well as others that buy goods produced in Cambodia, like Gap, Adidas and Nike. NPEs are likely applied as surfactants during production and subsequently break down to form toxic nonylphenol, a persistent chemical with hormone-disrupting properties, hazardous even at low levels. Nonylphenol is an active ingredient in detergents, pesticides and spermicides, but is not currently regulated in Cambodia.

While the FLA findings hint at how quickly such chemicals can impact workers under insufficient ventilation, a Better Factories Cambodia (BFC) report from January 2012 went a step further. BFC, a project of the International Labour Organization, monitors factories with registered export licenses to gauge compliance. The 2012 report, focusing on factors that could contribute to fainting, looks at 169 of the 300 registered factories.

BFC found acceptable heat levels in only 38 percent of plants. Plus: a drop in adequate ventilation systems in 13 percent more factories than the previous year, a 6 percent drop in factories properly labeling chemicals in Khmer and a 5 percent drop in factories properly storing chemicals in a separate area of the work place. In other words: 104 factories of those monitored were unacceptably hot (or if we extrapolate, approximately 186 of the 300 registered factories) and increasing numbers of plants were failing to label, store or properly disperse chemicals during and after use. In combination with the simple facilities issues BFC reported - 46 percent do not provide dust masks to workers, 71 percent do not have chairs located near workstations to provide rest areas, 97 percent do not maintain sufficient lighting - it becomes clear how quickly a tiny chemical leak might impact workers in the hundreds or more. Also relevant: that 68 percent of the factories inspected did not have medical staff working the legally required number of hours. If workers feel ill, in other words, there are few options besides falling to the floor.

Yet, BFC also tracked worker hygiene, health facilities, working hours and factors that contribute to strained managerial relationships - stress, in other words. It found that 52 percent of the factories monitored didn't have enough soap, water or working toilets for laborers and that the maximum allowable overtime was regularly exceeded. Working hours, under Cambodian law, are 48 per week maximum, eight hours per day, six days per week. Overtime is to be offered on an exceptional and voluntary basis, for urgent work only and for no more than two hours per day. This law was adhered to in only 16 percent of the factories monitored. The law also stipulates that overtime be paid at 150 percent normal rate (usually .29$ per hour), unless the work is on a Sunday, when it is to be paid at 200 percent. In the factories monitored, Sunday work was common and 70 percent of the overtime offered appeared to be both voluntary and exceptional. However, a full 95 percent of factories monitored did not limit overtime hours to exceptional work; and 84 percent did not limit overtime to two hours per day.

So, overwork is common, but stress increases if workers are not properly compensated. Because BFC monitors only during scheduled visits, planned with managerial staff and owners in advance, the organization tracks overtime compensation elliptically, by mandating the use of a single payroll ledger, a rule only 58 percent of the factories complied with - a 16 percent drop over the previous year. (Multiple payroll ledgers can mean overtime hours worked are kept from monitors.) Additionally, management failed to engage workers in occupational health and safety committees or shop steward elections in half the factories monitored and interfered in union activities - 4 percent discriminated against them entirely and 5 percent interfered in workers' rights to assembly.

Of course, general worker nutrition and the lack of a morning meal are common and were noted in the BFC report as contributory causes to the mass fainting incidents.

Those are the on-the-books violations. Things also fall through the cracks. Although the Ministry of Commerce requires BFC registration for export licenses, the organization also tracks some plants without export licenses. While these licenses may be in process, Cambodia's reputation for corruption is significant. Black factories, therefore, happen: plants that employ workers, fill orders, even export goods - illegally. Often laborers aren't aware they work in what is essentially a criminal enterprise. (Comparing BFC employee counts to those provided by the Ministry of Commerce gives us a difference of about 20,000 potential employees of such factories.) Of the plants at which fainting incidents occurred, neither Shingly Garment Factory nor Chime Ly Garment Factory are currently listed on either the GMAC web site or the BFC's list of monitored factories. Huey Chuen and Nanguo are also unlisted with the BFC (although as a sports shoe factory, Huey Chuen may not be eligible under the BFC's current garment-focused initiative).

So, some factories aren't being monitored. Those that are provide a long list of potential causes of a mass disaster - although not a dramatic list. Each single failure to comply with a minor legal code simply increases the likelihood of trouble - although better a series of mysterious faintings than another Triangle Fire.

Yet, ask a garment worker, organizer or factory monitor why around 3,000 women fainted on the job over the last year and you're going to get a sympathetic look that means, "That's just the fashion industry."

The Culprit

Perhaps BFC's most damning statement is not to be found in its report, but in the introduction: "The occurrence of the fainting incidents has coincided with a growth in the garment industry," the executive summary states. According to the Phnom Penh Post, garment exports from Cambodia rose by 34 percent over 2010, to $3.47 billion in the first 10 months of 2011 - roughly the same period that saw a 7.5 percent increase in the number of active factories and only a 3.6 percent increase in the number of workers (using Ministry of Commerce numbers).

BFC is referring to the garment industry in Cambodia, but the entire consumer fashion industry has changed in recent years. Inditex, the largest clothing retailer in the world, owner of Zara and other stores, and H&M, the second largest - both rely heavily on apparel made in Cambodia - have led the industry in abolishing first two new lines of fashion per year, then four. The embrace of fast fashion can mean a whole store's stock turns over in as little as two weeks, one H&M retail employee told me.

Where are those goods going? Some, of course, are being sold. Of the 2300 currently operating H&M retail stores, 168 opened last year, a growth of 7.3 percent. Yet, in a January 2010 New York Times article, Jim Dwyer reported whole bags filled with unworn items, slashed to prevent use, discarded on a regular basis behind an H&M in Manhattan. Inditex opened 483 new Zara stores in 2011, making 5,527 worldwide, according to a March 21, 2012, BBC story. Five hundred and twenty new stores are planned for this year.

More important, where are those goods coming from? Are the increasing demands from 8.3 percent more retail outlets over last year being adequately met by 3.6 percent more workers?

Perhaps the real question is: how did Cambodian garment exports increase by 34 percent last year - with double-digit percentage increases the year before that and another double-digit jump expected this year, too - with only 3,000 workers, with inadequate food, health care or safety facilities, falling to the ground from exhaustion?

Reframing the Debate

Without a drastic change to the way we think and talk about and therefore create policy for the fashion industry, the Titanic that is the international garment trade will just keep sinking, bringing more and more of the women who labor in the industry down with it. Slowly and surely.

The fainting incidents that took place in Cambodia, keep in mind, are the product of a best-case scenario in the current global fashion trade. Still recovering from the destruction of resources caused by American bombings, the Pol Pot era and civil war, Cambodia first got into the garment sector in the mid-1990s to take advantage of quota systems that offered developing nations a shot at exporting apparel to major markets. This was after the term "sweatshop" had become an indicator of unfair labor conditions, made popular by media exposés and student activists, so Cambodia established its entire industry with the intention of remaining "sweatshop-free." This meant workers' rights to organize were protected, monitoring facilities were brought in from the start - created by the International Labour Organization itself - and strong labor laws were established to fairly compensate employees in the emerging field.

Yet, the term "sweatshop" is not a legal one - it's a marketing one, or an anti-marketing one - so definitions remain hazy. ("No one knows what that is," a BFC monitor told me once when I asked him, naïvely, how many sweatshops he'd visited.) Most organizations and the US government, agree that a "sweatshop" is a factory in violation of one or more laws concerning: minimum wage and overtime, child labor, occupational safety and health, workers' compensation, rights to assembly or industry regulation.

That some Cambodian factories are in violation of one or more such laws, however, doesn't mean that the term "sweatshop" will change anything. (Some factories are not in technical violation of any laws, for example those that support workers' rights to organize, but that doesn't mean unions effectively protect labor. The same argument can be made about the minimum wage: Even factories that pay it, regularly and on time, with benefits etc., are still not paying enough to keep the workforce healthy.) I can't count how many stories smart editors have rejected on the Cambodian garment industry, claiming people are tired of reading about sweatshops. The term seems to lose all meaning entirely when New York Times columnist Nicholas Kristof takes "sweatshop" as another word for "factory" and calls for more of them in places like Cambodia, as he did in a 2009 column.

More important, here in the US, we hold our privilege of consumer choice as dear as democracy. We may advocate for boycotts of the brands that produce clothes in Cambodia, but an anti-marketing campaign would be a tactical error that would spell bad luck for the workers in those factories.

Consider this statement from the GMAC's Ken Loo in the Phnom Penh Post on February 7: "Some buyers are reluctant to come to Cambodia due to the high level of media coverage." The Post summarized his remarks thus: "The increase in media coverage of Cambodian garment factories since a spate of mass fainting incidents last year roused reporters' interest and threatened to revive the 'sweatshop' label."

How far the GMAC, the lobbying organization of the nation's fast-growing garment sector, or the Cambodian government itself, might go to protect its "sweatshop-free" status is an open question.

Continued Unrest

Protests around issues raised in the aftermath of the mass faintings continue. Workers at M&V tried to strike in October, the Phnom Penh Post reported, and some were fired, illegally, for trying to join a union. The $5 health bonus that went into effect in the beginning of the year, intended to incentivize regular meals, also inspired strikes. Workers, confused about the distribution of the bonus and concerned about other pay withholdings, went on strike January 3. Thousands have joined rallies in response to issues raised by recent inspections and reported. Police response is becoming increasingly violent.

Then, last month, a protest at Kaoway Sports, Ltd., another supplier for Puma in Bavet City, in the southeast Svay Rieng district, ended in gunfire. The rally - human rights groups list as many as 6,000 in attendance, although officials claimed a more modest 1,000 - called for a $10 raise to the monthly minimum wage and aimed to highlight unfair workplace conditions. On February 20, a man in a guard uniform opened fire, but despite heavy police presence, escaped from the scene undetected. Three workers were injured. One was reportedly shot in the chest and coughing up blood, according to the Deutsche-Press Agentur.

The only suspect in the shootings was Bavet City Gov. Chhuk Bundith. He was publicly removed from his post by Prime Minister Hun Sen, then went into hiding, according to RFA. On March 9, the station reported, in a document co-signed by Gap, H&M, American Eagle Outfitters, and other big-name brands, Puma sent a letter urging the government to investigate the matter.

Chhuk Bundith was summoned to court a few days later, although not arrested. "He confessed to the shooting, but he gave me many reasons for that," Hing Bun Chea, the Svay Rieng provincial prosecutor, told the Post on March 16.

The injured women are bringing a suit against Chhuk Bundith and Hing Bun Chea has agreed to meet with them to hear details of their case. The women say Chhuk Bundith attempted to buy off their silence and others have argued that the government continues to shield him from the law. The original meeting, set for March 28, was canceled because the prosecutor was "busy," the Post reported on March 29.

It's enough to make you give up and fall, seemingly lifeless, to the floor.

Solutions

In February, the advocacy group Asian Floor Wage Campaign put on the first-ever People's Tribunal on the Asia Minimum Floor Wage. The organization describes its mission as to lay "a floor under the race to the bottom and end wage competition in Asia and the extreme exploitation of women workers." The organization's pan-Asian approach overlooks that the rivalry among Asian - or even Southeast Asian - nations is what brings the industry there in the first place, and it's easy to see where countries with more labor law violations or lower wages than Cambodia would take precedence. Yet, the organization is calling for the addition of a labor cost to the price buyers pay for goods to meet living-wage levels - an excellent place to begin stopping leaks on this Titanic.

In country, the BFC will continue worker education and media campaigns, based on the success of its 2011 Garment Worker Open University, a similar daylong labor law workshop for managers, and 2010's "At the Factory Gates," a televised soap opera about garment workers' legal rights. "BFC will run many activities to raise awareness of workers' health and safety," communications officer Ying Bun told me over email. He described a mobile phone project - "in which workers can call in to seek for information about safety and health conditions" - a concession to the cell phones most own, made cheap by intense competition in the emerging Cambodian telecommunications market.

Ying Bun also told me about other "activities to prevent faintings," including the intriguingly named "TV Comedy Show," and a "radio competition for garment workers on the knowledge of Cambodian Labor."

Such solutions may sound like rearranging deck chairs on a sinking ship to US consumers, but until you're willing to demand your favorite brands pay more for your clothes - and are willing yourself to double what you pay for cheap fashion to back it up - rearranging deck chairs is going to have to do for now.

Anne Elizabeth Moore is a USC Annenberg/Getty Arts Journalism Fellow, Weinberg Fellow at the Newberry Library, a Fulbright scholar, and the author of several award-winning non-fiction books including Unmarketable (The New Press, 2007) and Cambodian Grrrl (2011). Co-editor and publisher of now-defunct Punk Planet and the founding editor of the Best American Comics series from Houghton Mifflin, Moore teaches at the School of the Art Institute of Chicago. She contributes criticism to The New Inquiry, The Baffler, N+1p and many others and writes a monthly comic strip for Truthout called Ladydrawers on gender, labor, and culture. Her latest book from Cantankerous Titles, New Girl Law, was called “A post-empirical, proto-fourth-wave feminist memoir” by Bust Magazine.

Sina Phin, a garment worker, right, ironing shirts at the New Island factory in outlying Phnom Penh, Cambodia, in April 2005. (Photo: Michael Nagle / The New York Times)

About a year ago, record numbers of garment laborers in factories across Cambodia - which exports 70 percent of the garments manufactured there to the US - were reported to be suddenly and mysteriously falling to the ground, unconscious. Hundreds at a time - sometimes less, although sometimes more. Workers at many scenes reported foul smells, difficulty breathing. Halting investigations took place at select plants by various parties involved: government officials; labor unions; human rights groups; business associations; monitoring organizations; and, weirdly, the international big-name brands that sell the clothes being made. A consortium of factors was considered: hypoglycemia, the direct result of workers not eating enough; minor factory infractions that managers promised to address immediately; a common cold outbreak emanating from Canada; overwork; mass hysteria; workers partying too hard over the weekend; and spiritual possession. In the end, no single cause was named for the nationwide epidemic. Besides a 5$ "health bonus" for qualifying workers, no sweeping policy changes were offered to keep the incidents from continuing.

It seemed to be just more bad luck for Cambodia, a nation still coming to terms with five decades spent surviving a record tonnage of American bombs, the Khmer Rouge, a generation of civil war, a legacy of corruption and endemic poverty. But bad luck doesn't account for around 3,000 workers reportedly losing consciousness in 17 separate mass-fainting incidents at 12 of the country's 300 registered garment factories.

The real bad luck for Cambodia - and ethical apparel consumers, particularly in the US, where 70 percent of the goods produced are sold - is that thousands of workers falling ill on the job isn't enough to catch the fashion industry's attention.

Background

Life in the Cambodian garment factories is not what anyone would call easy, even under ideal conditions. The minimum wage was increased to $61 per month at the beginning of 2011, still significantly less than the $93 per month living wage. But garment workers don't just cover their own costs - about a fifth of the country's 14 million people rely on their paychecks to support rice farms in the provinces. (That's right, the developing country's third-largest income generator, garment work, supports the country's second - agriculture.) Many workers labor seven days per week and take on as much overtime as possible, to earn enough to send $50 or $60 home every month. A tiny rental near the factories costs around $25 per month - you can get something bigger to split among more workers, although rents of less than $15 per month are rare - and utilities run between $5 and $10 per month. Drinking and cooking water costs have to be covered, too. And transportation, if needed. Even with the wage increase, funds are tight.

Everyone skimps on health care, which under the Pol Pot regime thirty-five years ago meant untrained cadre inventing balms and pills with accessible materials like leaves, mud and dung, since doctors were purged alongside intellectuals and previous government officials. The country is still rebuilding, and while health facilities are supposed to be provided in factories, they're often insufficient.

Many skimp on food. It's hard to eat in Cambodia for less than $1.25 per day. A 2009 Cambodian Institute of Development Study found that workers are often left with between $4 and $9 per month for meals. Workers who faint from hunger or the stifling heat on the factory floor - it's common enough - may find themselves without a job when they awake.

Unions have a robust life and that would seem, from a distance, to help. There are 650 registered unions in Cambodia, operating in the 300 registered factories. But yellow unions - company-backed organizations that push through management decisions - are common, as are competitive unions within one factory. Occasionally, two different unions that are members of the same federation will operate competing branches. With an average of six unions per factory, there's a lot of in-fighting and little in the way of actual organizing. On top of which, the all-male union leadership tends to act with little regard for female workforce concerns.

One shining example of union impotency was a series of strikes from September 13 through 16, 2010. Of the 300,000-strong workforce at the time, between one- and two-thirds had walked off jobs to demand a raise to the minimum wage - then only $55 per month. Management reaction was swift and strange: 26 labor leaders were "banned" from jobs. Not fired - that would violate laws protecting workers' rights to organize - just not allowed to enter buildings where they worked. Cohesive demands for more money splintered into protests against what amounted to illegally fired workers. These were met with more illegal firings, which led to more protests and increasing violence on all sides. The number of laborers effectively out of work over what was originally a demand for a wage increase quickly grew - some estimate into the thousands. Even after things calmed down in January 2011, some 300 illegally fired workers remained out of work at 20 factories around the country.

The back story to the mass fainting incidents is this: During the last months of 2010, up to two-thirds of the entire Cambodian garment industry had cohesively come together to make demands as a unified voice, in a democratic nation, with legal protection for workers' rights to organize. Yet somehow, one organizer told me, "Nothing happened." She looked crushed.

The Domino Effect

A few months after these mass, failed protests, huge numbers of workers started falling to the ground. Coverage of mass faintings in the press began with an incident on April 9 and 10, 2011, when 300 employees of the Huey Chuen garment factory and, next door, 500 employees of Universal Apparel Co. Ltd., fainted, according to both Reuters and The Guardian UK. (Deutsche-Press Agentur originally claimed 200 workers fell that day; Agence France-Presse listed only 101. These discrepancies were later attributed to counts based on hospitalized, instead of injured, workers, at two distinct sites.) The Guardian UK reported that, on June 15, 200 more employees experienced "a bad smell" before collapsing at King Fashion Garment, also in Phnom Penh. The next day, according to the same paper, another 100 fell. Fashion-industry news site Just-style.com notes that on July 25, 49 more workers were hospitalized after another incident at Huey Chuen garment factory, a story confirmed by Deutsche-Press Agentur. That same day, around 100 workers fainted at Hung Wah Textiles in the capital city, reported VOA Khmer. (Reuters claims 300 workers fell in July, but does not provide a date, wefhile other sources claim a mass fainting incident took place on July 21. Neither were confirmed by other sources.) On August 24, 85 more workers fainted after complaining of unusual odors at the M&V International Manufacturing, Ltd. plant in the central Kampong Chhnang province, according to Reuters, which reported nearly 200 more workers collapsing at the same factory the next day. On August 26, Radio Free Asia (RFA) told of 20 workers losing consciousness at the Shingly Garment Factory in the capital. Four days later, the station reported, more than 100 workers had collapsed on the job at the Chime Ly Garment Factory in the Kandal province in southern Cambodia. More smells were reported there; this time, guards outside factory doors fainted, too. Then, on August 31, more than 50 workers fell at Heart Enterprise Garment Factory in southern Kandal province, according to RFA.

For a time, the faintings were eclipsed by the big-name brands rushing to look into them. Swedish clothing retailer H&M, which buys garments from the M&V and Hung Wah plants, investigated over the summer. In a July 22 email to Reuters, the company stated, "Worker's health and safety in our supplier factories is of high priority to H&M. Accordingly, we have immediately started investigations ..." German sportswear company Puma, the sole purchaser of shoes made in the Huey Chuen factory, had the Fair Labor Association (FLA) draw up a report.

Findings were mixed: H&M, the world's second-largest clothing manufacturer, concluded their investigation by the end of August. No "plausible causes" had been discovered for the faintings, Just-style.com reported. The FLA, a non-profit organization funded by affiliate clothing, footwear and consumer goods companies, boasts a mission to promote adherence to national and international labor laws. Although the organization stands accused of deep conflicts of interest that cast shadows over all findings - releasing glowing reports of Foxconn factories in China paid for by Apple, for example - even it noted clear violations of domestic labor law and Puma's contractor code of conduct, as well as worker malnutrition at the Huey Chuen plant. On July 26, Just-style.com reported only that hypoglycemia had been diagnosed.

The Cambodian government got into the act, too. Following the Heart Enterprise incident, the ministers of industry, labor, social affairs and health portfolios inspected the factory and condemned it for unhygienic conditions and overcrowded workspaces. Factory management, however, wrote the incident off as having been caused by "spiritual possession," RFA reported on August 31. (Ken Loo, secretary general of the Garment Manufacturing Association of Cambodia, or GMAC, theorized that since "many incidents of mass fainting in Cambodian factories have occurred on a Monday ... workers may have become over-involved with social activities on the weekend before returning to work," RFA reported on February 14.)

A brief pause, then more mass faintings. On October 24, 100 (RFA listed a remarkable 1,000 and the Australian Broadcasting Company, or ABC, reported 136) workers fell ill at the Anful Garment Factory - another producer for H&M - in southern Kampong Speu Province, according to Reuters. The factory closed for two days - claiming to give workers time to rest, although foul smells from an insecticide sprayed on shirts on Sunday had been reported - and when the factory opened again on October 27, over 200 more workers fainted. (ABC listed 100.)

Toward the end of 2011, reports of mass faintings become more sporadic and fewer are confirmed by multiple sources. On December 8, China Daily reported 59 workers collapsed at the Sportex Industry factory in Phnom Penh. On January 24, 2012, the Cambodia Daily reported 60 workers fell at the Taiwanese-owned King First Industrial Co Ltd. in the capital. RFA reported 300 workers fainted at Nanguo Garment Co. Ltd. in Sihanoukville, southwest of the capital, on February 14. (The Phnom Pehn Post confirms only 201 faintings that day.) On March 6, the Post reported 50 more workers fell at the same factory.

The stories conflict and at times contradict. While exact numbers of fainted - as opposed to ill, hospitalized or fallen - workers are disputed, that a record numbers of faintings took place was never questioned. Causes were offered. Plausible, comprehensive explanations were not.

Causes

Part of the story here is that garment factory faintings sort of aren't news. Many factories admit to as many as between one and five per week and the Phnom Penh Post reported 20 workers had fainted at M&V before these incidents started occurring, on September 23, 2010. At a Kampong Cham high school in November 2011, school officials intended to quell concerns about the ongoing incidents around the country. The Post reported that 136 students in attendance lost consciousness. It's a hot country, with not a lot of wind. People faint.

Time, however, isn't buying it - a shame, as it was among the only major US media outlets to acknowledge the mass faintings at all. Noting only seven of the nine incidents that had taken place by the article's appearance on September 20, 2011, Andrew Marshall described them as mass hysteria, "a bizarre yet surprisingly common phenomenon that is increasingly recognized as a significant health and social problem," and wrote the incidents off as "psychogenic fainting."

Marshall's unresearched pronouncement smacks of privilege, misogyny and racism - look what those crazy brown women are doing now! - but more problematic, doesn't account for a single environmental factor suggested by eyewitness accounts.

"There is a strong possibility that the fainting and illness reported are due to the type of chemicals used in the factory and the way they are used," the Fair Labor Association noted in the July 18, 2011, report on the Huey Chuen incidents. "While there are a large number of ventilation fans, these do not appear to be effective ... [and] a chemical was found that, according to the producers' website, contains toluene."

Use of toxic toluene - the chemical at work in "huffing" - is a violation of Puma's supplier factory regulations. The Environmental Protection Agency claims the solvent damages the central nervous system. Low levels of the stuff can cause dizziness, while at moderate levels, a loss of consciousness.

While toluene wasn't found at each site - an athletic shoe manufactory will have a different set of environmental factors than garment plants - Greenpeace released a commissioned report called "Dirty Laundry 2" on August 23, 2011, that could point to the use of other toxins. The report stated that nonylphenol ethoxylates (NPEs), banned in the UK, are being found in clothes from top labels - including H&M and Puma, as well as others that buy goods produced in Cambodia, like Gap, Adidas and Nike. NPEs are likely applied as surfactants during production and subsequently break down to form toxic nonylphenol, a persistent chemical with hormone-disrupting properties, hazardous even at low levels. Nonylphenol is an active ingredient in detergents, pesticides and spermicides, but is not currently regulated in Cambodia.

While the FLA findings hint at how quickly such chemicals can impact workers under insufficient ventilation, a Better Factories Cambodia (BFC) report from January 2012 went a step further. BFC, a project of the International Labour Organization, monitors factories with registered export licenses to gauge compliance. The 2012 report, focusing on factors that could contribute to fainting, looks at 169 of the 300 registered factories.

BFC found acceptable heat levels in only 38 percent of plants. Plus: a drop in adequate ventilation systems in 13 percent more factories than the previous year, a 6 percent drop in factories properly labeling chemicals in Khmer and a 5 percent drop in factories properly storing chemicals in a separate area of the work place. In other words: 104 factories of those monitored were unacceptably hot (or if we extrapolate, approximately 186 of the 300 registered factories) and increasing numbers of plants were failing to label, store or properly disperse chemicals during and after use. In combination with the simple facilities issues BFC reported - 46 percent do not provide dust masks to workers, 71 percent do not have chairs located near workstations to provide rest areas, 97 percent do not maintain sufficient lighting - it becomes clear how quickly a tiny chemical leak might impact workers in the hundreds or more. Also relevant: that 68 percent of the factories inspected did not have medical staff working the legally required number of hours. If workers feel ill, in other words, there are few options besides falling to the floor.

Yet, BFC also tracked worker hygiene, health facilities, working hours and factors that contribute to strained managerial relationships - stress, in other words. It found that 52 percent of the factories monitored didn't have enough soap, water or working toilets for laborers and that the maximum allowable overtime was regularly exceeded. Working hours, under Cambodian law, are 48 per week maximum, eight hours per day, six days per week. Overtime is to be offered on an exceptional and voluntary basis, for urgent work only and for no more than two hours per day. This law was adhered to in only 16 percent of the factories monitored. The law also stipulates that overtime be paid at 150 percent normal rate (usually .29$ per hour), unless the work is on a Sunday, when it is to be paid at 200 percent. In the factories monitored, Sunday work was common and 70 percent of the overtime offered appeared to be both voluntary and exceptional. However, a full 95 percent of factories monitored did not limit overtime hours to exceptional work; and 84 percent did not limit overtime to two hours per day.

So, overwork is common, but stress increases if workers are not properly compensated. Because BFC monitors only during scheduled visits, planned with managerial staff and owners in advance, the organization tracks overtime compensation elliptically, by mandating the use of a single payroll ledger, a rule only 58 percent of the factories complied with - a 16 percent drop over the previous year. (Multiple payroll ledgers can mean overtime hours worked are kept from monitors.) Additionally, management failed to engage workers in occupational health and safety committees or shop steward elections in half the factories monitored and interfered in union activities - 4 percent discriminated against them entirely and 5 percent interfered in workers' rights to assembly.

Of course, general worker nutrition and the lack of a morning meal are common and were noted in the BFC report as contributory causes to the mass fainting incidents.

Those are the on-the-books violations. Things also fall through the cracks. Although the Ministry of Commerce requires BFC registration for export licenses, the organization also tracks some plants without export licenses. While these licenses may be in process, Cambodia's reputation for corruption is significant. Black factories, therefore, happen: plants that employ workers, fill orders, even export goods - illegally. Often laborers aren't aware they work in what is essentially a criminal enterprise. (Comparing BFC employee counts to those provided by the Ministry of Commerce gives us a difference of about 20,000 potential employees of such factories.) Of the plants at which fainting incidents occurred, neither Shingly Garment Factory nor Chime Ly Garment Factory are currently listed on either the GMAC web site or the BFC's list of monitored factories. Huey Chuen and Nanguo are also unlisted with the BFC (although as a sports shoe factory, Huey Chuen may not be eligible under the BFC's current garment-focused initiative).

So, some factories aren't being monitored. Those that are provide a long list of potential causes of a mass disaster - although not a dramatic list. Each single failure to comply with a minor legal code simply increases the likelihood of trouble - although better a series of mysterious faintings than another Triangle Fire.

Yet, ask a garment worker, organizer or factory monitor why around 3,000 women fainted on the job over the last year and you're going to get a sympathetic look that means, "That's just the fashion industry."

The Culprit

Perhaps BFC's most damning statement is not to be found in its report, but in the introduction: "The occurrence of the fainting incidents has coincided with a growth in the garment industry," the executive summary states. According to the Phnom Penh Post, garment exports from Cambodia rose by 34 percent over 2010, to $3.47 billion in the first 10 months of 2011 - roughly the same period that saw a 7.5 percent increase in the number of active factories and only a 3.6 percent increase in the number of workers (using Ministry of Commerce numbers).

BFC is referring to the garment industry in Cambodia, but the entire consumer fashion industry has changed in recent years. Inditex, the largest clothing retailer in the world, owner of Zara and other stores, and H&M, the second largest - both rely heavily on apparel made in Cambodia - have led the industry in abolishing first two new lines of fashion per year, then four. The embrace of fast fashion can mean a whole store's stock turns over in as little as two weeks, one H&M retail employee told me.

Where are those goods going? Some, of course, are being sold. Of the 2300 currently operating H&M retail stores, 168 opened last year, a growth of 7.3 percent. Yet, in a January 2010 New York Times article, Jim Dwyer reported whole bags filled with unworn items, slashed to prevent use, discarded on a regular basis behind an H&M in Manhattan. Inditex opened 483 new Zara stores in 2011, making 5,527 worldwide, according to a March 21, 2012, BBC story. Five hundred and twenty new stores are planned for this year.

More important, where are those goods coming from? Are the increasing demands from 8.3 percent more retail outlets over last year being adequately met by 3.6 percent more workers?

Perhaps the real question is: how did Cambodian garment exports increase by 34 percent last year - with double-digit percentage increases the year before that and another double-digit jump expected this year, too - with only 3,000 workers, with inadequate food, health care or safety facilities, falling to the ground from exhaustion?

Reframing the Debate

Without a drastic change to the way we think and talk about and therefore create policy for the fashion industry, the Titanic that is the international garment trade will just keep sinking, bringing more and more of the women who labor in the industry down with it. Slowly and surely.

The fainting incidents that took place in Cambodia, keep in mind, are the product of a best-case scenario in the current global fashion trade. Still recovering from the destruction of resources caused by American bombings, the Pol Pot era and civil war, Cambodia first got into the garment sector in the mid-1990s to take advantage of quota systems that offered developing nations a shot at exporting apparel to major markets. This was after the term "sweatshop" had become an indicator of unfair labor conditions, made popular by media exposés and student activists, so Cambodia established its entire industry with the intention of remaining "sweatshop-free." This meant workers' rights to organize were protected, monitoring facilities were brought in from the start - created by the International Labour Organization itself - and strong labor laws were established to fairly compensate employees in the emerging field.

Yet, the term "sweatshop" is not a legal one - it's a marketing one, or an anti-marketing one - so definitions remain hazy. ("No one knows what that is," a BFC monitor told me once when I asked him, naïvely, how many sweatshops he'd visited.) Most organizations and the US government, agree that a "sweatshop" is a factory in violation of one or more laws concerning: minimum wage and overtime, child labor, occupational safety and health, workers' compensation, rights to assembly or industry regulation.

That some Cambodian factories are in violation of one or more such laws, however, doesn't mean that the term "sweatshop" will change anything. (Some factories are not in technical violation of any laws, for example those that support workers' rights to organize, but that doesn't mean unions effectively protect labor. The same argument can be made about the minimum wage: Even factories that pay it, regularly and on time, with benefits etc., are still not paying enough to keep the workforce healthy.) I can't count how many stories smart editors have rejected on the Cambodian garment industry, claiming people are tired of reading about sweatshops. The term seems to lose all meaning entirely when New York Times columnist Nicholas Kristof takes "sweatshop" as another word for "factory" and calls for more of them in places like Cambodia, as he did in a 2009 column.

More important, here in the US, we hold our privilege of consumer choice as dear as democracy. We may advocate for boycotts of the brands that produce clothes in Cambodia, but an anti-marketing campaign would be a tactical error that would spell bad luck for the workers in those factories.

Consider this statement from the GMAC's Ken Loo in the Phnom Penh Post on February 7: "Some buyers are reluctant to come to Cambodia due to the high level of media coverage." The Post summarized his remarks thus: "The increase in media coverage of Cambodian garment factories since a spate of mass fainting incidents last year roused reporters' interest and threatened to revive the 'sweatshop' label."

How far the GMAC, the lobbying organization of the nation's fast-growing garment sector, or the Cambodian government itself, might go to protect its "sweatshop-free" status is an open question.

Continued Unrest

Protests around issues raised in the aftermath of the mass faintings continue. Workers at M&V tried to strike in October, the Phnom Penh Post reported, and some were fired, illegally, for trying to join a union. The $5 health bonus that went into effect in the beginning of the year, intended to incentivize regular meals, also inspired strikes. Workers, confused about the distribution of the bonus and concerned about other pay withholdings, went on strike January 3. Thousands have joined rallies in response to issues raised by recent inspections and reported. Police response is becoming increasingly violent.

Then, last month, a protest at Kaoway Sports, Ltd., another supplier for Puma in Bavet City, in the southeast Svay Rieng district, ended in gunfire. The rally - human rights groups list as many as 6,000 in attendance, although officials claimed a more modest 1,000 - called for a $10 raise to the monthly minimum wage and aimed to highlight unfair workplace conditions. On February 20, a man in a guard uniform opened fire, but despite heavy police presence, escaped from the scene undetected. Three workers were injured. One was reportedly shot in the chest and coughing up blood, according to the Deutsche-Press Agentur.

The only suspect in the shootings was Bavet City Gov. Chhuk Bundith. He was publicly removed from his post by Prime Minister Hun Sen, then went into hiding, according to RFA. On March 9, the station reported, in a document co-signed by Gap, H&M, American Eagle Outfitters, and other big-name brands, Puma sent a letter urging the government to investigate the matter.

Chhuk Bundith was summoned to court a few days later, although not arrested. "He confessed to the shooting, but he gave me many reasons for that," Hing Bun Chea, the Svay Rieng provincial prosecutor, told the Post on March 16.

The injured women are bringing a suit against Chhuk Bundith and Hing Bun Chea has agreed to meet with them to hear details of their case. The women say Chhuk Bundith attempted to buy off their silence and others have argued that the government continues to shield him from the law. The original meeting, set for March 28, was canceled because the prosecutor was "busy," the Post reported on March 29.

It's enough to make you give up and fall, seemingly lifeless, to the floor.

Solutions

In February, the advocacy group Asian Floor Wage Campaign put on the first-ever People's Tribunal on the Asia Minimum Floor Wage. The organization describes its mission as to lay "a floor under the race to the bottom and end wage competition in Asia and the extreme exploitation of women workers." The organization's pan-Asian approach overlooks that the rivalry among Asian - or even Southeast Asian - nations is what brings the industry there in the first place, and it's easy to see where countries with more labor law violations or lower wages than Cambodia would take precedence. Yet, the organization is calling for the addition of a labor cost to the price buyers pay for goods to meet living-wage levels - an excellent place to begin stopping leaks on this Titanic.

In country, the BFC will continue worker education and media campaigns, based on the success of its 2011 Garment Worker Open University, a similar daylong labor law workshop for managers, and 2010's "At the Factory Gates," a televised soap opera about garment workers' legal rights. "BFC will run many activities to raise awareness of workers' health and safety," communications officer Ying Bun told me over email. He described a mobile phone project - "in which workers can call in to seek for information about safety and health conditions" - a concession to the cell phones most own, made cheap by intense competition in the emerging Cambodian telecommunications market.

Ying Bun also told me about other "activities to prevent faintings," including the intriguingly named "TV Comedy Show," and a "radio competition for garment workers on the knowledge of Cambodian Labor."

Such solutions may sound like rearranging deck chairs on a sinking ship to US consumers, but until you're willing to demand your favorite brands pay more for your clothes - and are willing yourself to double what you pay for cheap fashion to back it up - rearranging deck chairs is going to have to do for now.

Anne Elizabeth Moore is a USC Annenberg/Getty Arts Journalism Fellow, Weinberg Fellow at the Newberry Library, a Fulbright scholar, and the author of several award-winning non-fiction books including Unmarketable (The New Press, 2007) and Cambodian Grrrl (2011). Co-editor and publisher of now-defunct Punk Planet and the founding editor of the Best American Comics series from Houghton Mifflin, Moore teaches at the School of the Art Institute of Chicago. She contributes criticism to The New Inquiry, The Baffler, N+1p and many others and writes a monthly comic strip for Truthout called Ladydrawers on gender, labor, and culture. Her latest book from Cantankerous Titles, New Girl Law, was called “A post-empirical, proto-fourth-wave feminist memoir” by Bust Magazine.